Active NPI
Kathryn Elizabeth Melloch, CD
- Registered Dietitian
- Beloit, WI
National Provider Identifier
1609434406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3380-29
- Practice address
- Beloit Clinic
1905 E. Huebbe Parkway
Beloit, WI 53511-1842 - Phone
- (608) 364-1534
- Fax
- (608) 364-1534
- NPI assigned
- Jun 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 3380-29 | WI | Primary |
Addresses
Primary practice location
Beloit Clinic
1905 E. Huebbe Parkway
Beloit, WI 53511-1842
Mailing address
Beloit Clinic
1905 E. Huebbe Parkway
Beloit, WI 53511-1842
Phone (608) 364-1534
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3380-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1609434406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BELOIT CLINIC",
"address_2": "1905 E. HUEBBE PARKWAY",
"city": "BELOIT",
"state": "WI",
"postal_code": "535111842",
"telephone_number": "608-364-1534",
"fax_number": "608-364-1534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BELOIT CLINIC",
"address_2": "1905 E. HUEBBE PARKWAY",
"city": "BELOIT",
"state": "WI",
"postal_code": "535111842",
"telephone_number": "608-364-1534",
"fax_number": "608-364-1534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLOCH",
"first_name": "KATHRYN",
"middle_name": "ELIZABETH",
"credential": "CD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-05",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "3380-29",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beloit, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.